What exactly is Tension Myositis syndrome and the conditioned response?

‘Pavlov’s dogs’ demonstrates how the conditioned response begins.

In my previous blog (Snowboarding, A passion of two halves..) I briefly spoke about my personal experience with sport addiction, attachment and identity and how, it was a contributing factor in a gradual slide into psychophysiological pain. In this post I share with you, in brief, exactly what TMS is. Some of this information is also within the content of my website but I thought I’d rehash it here as a way to help reach more people.

Tension Myositis Syndrome (TMS), also known as Mind Body Syndrome (MBS), Psychophysiological Disorder (PPD), Neurophysiological Disorder (NPD) and Stress Illness, is a condition originally coined by the late John E. Sarno, MD, a retired professor of Clinical Rehabilitation Medicine at New York University School of Medicine, & attending physician at the Howard A. Rusk Institute of Rehabilitation Medicine at New York University Medical Center.

Despite what popular medicine might suggest, a minimum of 85% of chronic or unexplainable physical pain has an emotional component at its core. The primary emotions being repressed anger and fear.

TMS is responsible for upward of 85% of chronic or unexplained pain and symptoms. It causes physical symptoms, such as fibromyalgia and gastrointestinal issues that are not due to pathological or structural abnormalities and are not explained by diagnostic tests. The latest neuroscience research and empirical data suggests that with TMS symptoms are caused by learnt neural pathways via the central nervous system. Just like phantom limb pain (amputees can still experience chronic pain, even after a limb has been removed), the aching or stabbing in your body is the result of a conditioned response developed between your brain and body and not because of physical damage, structural abnormality or muscle imbalances etc. 

“According to a survey we did a number of years ago, 40 percent of a typical group of patients reported that the pain began in association with some kind of physical incident. For some it was a minor automobile accident, usually the hit-from-behind type. Falls, on the ice or down steps, were common. Lifting a heavy object or straining was another; and of course running, tennis, golf or basketball were often blamed. The pain began anywhere from minutes to hours or days after the incident, raising some important questions about the nature of pain. Some of the reported incidents were trivial, such as bending over to pick up a toothbrush or twisting to reach into a cupboard, but the ensuing pain might be just as excruciating as that experienced by someone who was trying to lift a refrigerator”  - Dr. John E Sarno

…Burn out, caused by over-working or thinking, while not prioritising downtime and play, can also produce symptoms. But then we have to ask, what has caused the burn out? We might find it still comes back to anger. Is it working too much or our anger towards the feeling of having to work too much, in a job we might not enjoy, or with colleagues we have resentment towards… And all the while, despite the obvious warning signs, we give no time for play, or emotional resolve.

In my experience, as a practitioner, I have noticed that loneliness, rumination and a lack of purpose can also lead to the manifestation of TMS. Deep down their is anger, anger at life not providing what we assumed it should… Family, community, connection (spiritual and physical) and friends. The moment an individual opens their heart back up to community, connection and love, symptoms begin to reduce and go away.

What is a conditioned response?

Have you heard the story of Pavlov’s dog's? Back in the 1890s, Russian physiologist, Ivan Pavlov was researching the salivation response of dogs, upon being fed. Pavlov’s prediction was that the dogs would salivate when food was placed in front of them, but what interested him more was that the dogs would begin salivating the moment they heard the assistants footsteps approaching. With this observation, he had stumbled upon an important discovery. In behaviourist terms food is considered an unconditioned stimulus and salivation is equally an unconditioned response. (i.e. a response that required no learning). A dog does not need to learn to salivate upon seeing food, it is an autonomic response, hardwired from birth. However, a dog does not inherently salivate upon hearing foot steps. If this happens, it is only through learnt conditioning that the animal has such an ability.

To further the experiment, Pavlov proceeded to begin ringing a bell each and every time the dogs were fed. Soon after this phase of the experiment, he would ring the bell just as before, but this time, much to the dogs disappointment, he would not present food. The dogs, however, would continue to salivate regardless.

This is a classic example of conditioning, in which the brain and body have learnt an association between two separate stimuli (the sight of food and the ringing bell) which leads to the production of physical symptoms (salivation) regardless of the reality of the situation. This exact style of conditioning is precisely how physical pain symptoms become learnt and persist.

And before I close, a little Neuroscience…

In neuroscience there is a saying, “Neurons that fire together, wire together”. A conditioned response results when two or more neuron’s repeatedly fire at the same time, creating an associated reaction.

Neurons are cells within the nervous system that transmit information to other nerve cells, muscles, or gland cells. In the case of TMS it is an emotional response that becomes wired to a physical (pain/symptom) response. This is also seen in post viral fatigue, chronic fatigue, lymes disease and other so called “chronic” conditions. The body has long since healed the acute condition but the brain has learnt the symptoms and has become stuck in a painful conditioned feedback loop between brain and body. We can consider the brain similar to a mockingbird. It is able to mimic the symptoms of illness long after the physical trauma or virus has passed.

I hope this helps clear up any misunderstandings over what Tension Myositis Syndrome, and the conditioned response are. If you have any other questions, or wish to reach out, do not hesitate to contact me via, email, phone, or Instagram.

Stay safe.

Duncan